高频双向喷射通气对气管隆突重建术患者呼吸循环的影响  

The effects of High frequency two -way jet ventilation on the function respiratory and circulation of patients with Trachea and Carinal reconstruction

作　　者：曹金军 刘国利[2] 

机构地区：[1]内蒙古林业总医院麻醉科,内蒙古自治区牙克石022150 [2]辽宁医学院附属第一医院麻醉科

出　　处：《中国基层医药》2015年第13期1971-1973,共3页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的：探讨高频双向喷射通气对气管隆突重建术患者呼吸循环的影响。方法15例择期肺癌需行气管隆突重建术患者，麻醉诱导插入双腔气管导管且静脉复合麻醉，气管隆突重建时行健侧主支气管高频双向喷射通气，连接一根 Hunsaker 喷射通气导管插入健侧主支气管内3 cm，呼吸频率（RR）120次／min，吸呼比（IE）11，驱动压力0．2-0．25 MPa。且在麻醉前、开胸单肺通气后15 min、高频通气10、20、30 min 及再次单肺通气15 min 时行动脉血气分析，同时监测 MAP、HR、SpO2、PetCO2。结果高频通气时 PaO2较术前的（78．0±10．5）mmHg 显著升高，分别为（161．4±10．2）mmHg、（156．0±15．7）mmHg、（153．0±15．1）mmHg （均 P ＜0．01）；高频通气30 min 时 PaO2较单肺（前）的（165．50±11．3）mmHg 通气降低为（153±15．1）mmHg （P ＜0．05），均高于100 mmHg；PaCO2在高频通气30 min 内较单肺通气（前）时稍增高，差异无统计学意义（P ＞0．05）。结论胸外科气管隆突成型重建术用高频双向喷射通气行健侧肺通气是安全可行的方法。Objective To study the effects of High frequency two -way jet ventilation on the function respiratory and circulation of patients with Trachea and Carinal reconstruction.Methods Fifty patients with lung cancer,who were scheduled for elective trachea and carinal reconstruction,were intubated with double lumen tube following anesthesia induction and general anesthesia.High frequency ventilation was used on the healthful main bronchus during carinal reconstruction,a Hunsaker tube was inserted 3cm into the healthful main bronchus.HFTJV was applied with the respiratory rate of 120 /min,the ratio of inspiration and expiration E =1：1 and drive pressure of 0.2 -0.25Mpa.Blood gas analysis was made before the anesthesia,15 min following one -lung ventilation,10,20, 30 min following HFTJV and 15min following one -lung ventilation,respectively and monitor MAP,HR,SpO2 , PetCO2 .Results PaO2 in high frequency ventilation increased significantly compared with preoperative （78.0 ± 10.5）mmHg,was respectively （161.4 ±10.2）mmHg,（156.0 ±15.7）mmHg,（153.0 ±15.1）mmHg （P 〈0.01）;PaO2 in high frequency ventilation 30min was （153.0 ±15.1）mmHg （P 〈0.05）.It was lower than single lung venti-lation （front 165.50 ±11.3mmHg）and higher than 100mmHg equally;PaCO2 in the high frequency ventilation was slightly increased compared with OLV 30min （front）,and the difference was not statistically significant （P 〉0.05）. Conclusion HFTJV is safe and reliable for Trachea and carinal reconstruction.

关 键 词：高频双向喷射通气 血气分析 血流动力学 气管隆突重建术 

分 类 号：R734.2[医药卫生—肿瘤]